Student Association For International Affairs

Trump’s Budget Cuts Deeply Into Medicaid and Anti-Poverty Efforts

WASHINGTON — President Trump plans to unveil on Tuesday a $4.1 trillion budget for 2018 that would cut deeply into programs for the poor, from health care and food stamps to student loans and disability payments, laying out an austere vision for reordering the nation’s priorities.

The document, grandly titled “A New Foundation for American Greatness,” encapsulates much of the “America first” message that powered Mr. Trump’s campaign. It calls for an increase in military spending of 10 percent and spending more than $2.6 billion for border security — including $1.6 billion to begin work on a wall on the border with Mexico — as well as huge tax reductions and an improbable promise of 3 percent economic growth.

The wildly optimistic projections balance Mr. Trump’s budget, at least on paper, even though the proposal makes no changes to Social Security’s retirement program or Medicare, the two largest drivers of the nation’s debt.

To compensate, the package contains deep cuts in entitlement programs that would hit hardest many of the economically strained voters who propelled the president into office. Over the next decade, it calls for slashing more than $800 billion from Medicaid, the federal health program for the poor, while slicing $192 billion from nutritional assistance and $272 billion over all from welfare programs. And domestic programs outside of military and homeland security whose budgets are determined annually by Congress would also take a hit, their funding falling by $57 billion, or 10.6 percent.

The plan would cut by more than $72 billion the disability benefits upon which millions of Americans rely. It would eliminate loan programs that subsidize college education for the poor and those who take jobs in government or nonprofit organizations.

Mr. Trump’s advisers portrayed the steep reductions as necessary to balance the nation’s budget while sparing taxpayers from shouldering the burden of programs that do not work well.

“This is, I think, the first time in a long time that an administration has written a budget through the eyes of the people who are actually paying the taxes,” said Mick Mulvaney, Mr. Trump’s budget director.

“We’re not going to measure our success by how much money we spend, but by how many people we actually help,” Mr. Mulvaney said as he outlined the proposal at the White House on Monday before its formal presentation on Tuesday to Congress.

Among its innovations: Mr. Trump proposes saving $40 billion over a decade by barring undocumented immigrants from collecting the child care tax credit or the earned-income tax credit, a subsidy for low- and middle-income families, particularly those with children. He has also requested $19 billion over 10 years for a new program, spearheaded by his daughter and senior adviser Ivanka Trump, to provide six weeks of paid leave to new parents. The budget also includes a broad prohibition against money for entities that provide abortions, including Planned Parenthood, blocking them from receiving any federal health funding

The release of the document, an annual ritual in Washington that usually constitutes a marquee event for a new president working to promote his vision, unfolded under unusual circumstances. Mr. Trump is out of the country for his first foreign trip, and his administration is enduring a near-daily drumbeat of revelations about the investigation into his campaign’s possible links with Russia.

The president’s absence, which his aides dismissed as a mere coincidence of the calendar, seemed to highlight the haphazard way in which his White House has approached its dealings with Congress. It is just as much a sign of Mr. Trump’s lack of enthusiasm for the policy detail and message discipline that is required to marshal support to enact politically challenging changes.

“If the president is distancing himself from the budget, why on earth would Republicans rally around tough choices that would have to be made?” said Robert L. Bixby, the executive director of the Concord Coalition, a nonpartisan organization that promotes deficit reduction. “If you want to make the political case for the budget — and the budget is ultimately a political document — you really need the president to do it. So, it does seem bizarre that the president is out of the country.”

The president’s annual budget — more a message document than a practical set of marching orders even in the best of times — routinely faces challenges on Capitol Hill. Lawmakers jealously guard their prerogative to control federal spending and shape government programs. But Mr. Trump’s wish list, in particular, faces long odds, with Democrats uniformly opposed and Republicans already showing themselves to be squeamish about some of the president’s plans.

“It probably is the most conservative budget that we’ve had under Republican or Democrat administrations in decades,” said Representative Mark Meadows, Republican of North Carolina and the chairman of the conservative House Freedom Caucus.

But in a signal that some proposed cuts to domestic programs are likely to face resistance even from conservatives, Mr. Meadows said he could not stomach the idea of doing away with food assistance for older Americans.

“Meals on Wheels, even for some of us who are considered to be fiscal hawks, may be a bridge too far,” Mr. Meadows said.

Republicans balked at Mr. Trump’s demand for money for the border wall in negotiations over a spending package enacted last month. Many were deeply conflicted over voting for a health care overhaul measure that included the Medicaid cuts contained in the budget to be presented on Tuesday. Now the president is proposing still deeper reductions to the federal health program for the poor, as well as drastically scaling back a broad array of social safety net programs that are certain to be unpopular with lawmakers.

“The politics of this make no sense to me whatsoever, in the sense that the population that brought them to the dance are the populists out there in the Midwest and South who rely on these programs that he’s talking about reducing,” said G. William Hoagland, a former senior Republican congressional budget aide. Referring to Representative Paul D. Ryan, he said: “I don’t see how Speaker Ryan gets anywhere close to 218 votes in the House of Representatives if this is the model. It’s an exercise in futility.”

Senator Chuck Schumer, Democrat of New York and the minority leader, said Monday that the Medicaid cuts would “carry a staggering human cost” and violate Mr. Trump’s campaign promise to address the opioid epidemic.

“Based on what we know about this budget, the good news — the only good news — is that it was likely to be roundly rejected by members of both parties here in the Senate, just as the last budget was,” Mr. Schumer said on the Senate floor.

The budget itself avoids some of the tough choices that would be required to enact Mr. Trump’s fiscal vision. The huge tax cut was presented but without any detail about its elements or cost. Mr. Mulvaney said the tax plan would not add to the deficit, implying that its cost would be made up with other changes, such as eliminating deductions.

To balance the budget, Mr. Trump’s budget relies on growth he argues will be generated from the as-yet-unformed tax cut.

The blueprint also steers clear of changing Social Security or Medicare, steps that Mr. Mulvaney, a former South Carolina congressman who has backed entitlement cuts, said he had tried to persuade Mr. Trump to consider.

“He said, ‘I promised people on the campaign trail I would not touch their retirement and I would not touch Medicare,’ and we don’t do it,” Mr. Mulvaney said. “I honestly was surprised that we could balance the budget without changing those programs, but we managed to do that.”

But budget experts argued that was little more than fiction, and the plan could never deliver the results it claims to.

“The central inconsistency is promoting a massive tax cut and spending increases in some areas and leaving the major entitlement programs alone,” Mr. Bixby said. “You don’t have to be an economist to know that that doesn’t add up, and that’s why there’s a great deal of concern about the negative fiscal impact that this budget will have.”

While past presidents have often launched a road show with stops around the country to promote the components of their inaugural budgets, Mr. Trump is spending the rest of the week overseas, leaving his staff to explain his plan while Republicans prepare their own response.

“This budget is dead before arrival, so he might as well be out of town,” said David A. Stockman, a former budget director under President Ronald Reagan.

Mr. Stockman said both political parties had grown comfortable with running large annual budget deficits. “There’s not a snowball’s chance that most of this deep deficit reduction will even be considered in a serious way.”